Promoting Amphetamines for Over-Eating - What Could Possibly Go Wrong?In this study, about 5% of patients given any dosage of Vyvanse had to discontinue its use because of adverse effects. 3/196 patients initially randomized to Vyvanse had serious adverse effects, and one patient died, apparently of an amphetamine overdose. Oddly, the article declared that the one death, due to methamphetamine overdose, was thought by a study investigator not to be related to treatment with another amphetamine, lisdexamfetamine. That makes little sense, given that in a randomized controlled trial, the presumption is that differences in groups given different treatments were caused by these ...Source: Health Care Renewal - February 26, 2015 Category: Health ManagementTags: clinical trials conflicts of interest deception evidence-based medicine FDA marketing Shire stealth marketing Source Type: blogs

LITFL Review 165Welcome to the 165th LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the WeekDo you re-spike IV fluid bags? The case of Ruby Chen from gravelessons.com should make us all re-think this. [SO]The Best of #FOAMed Emergency MedicineExcellent discussion of everything you need to know about AFib from EM Cases featuring Ian Stiell. ...Source: Life in the Fast Lane - January 19, 2015 Category: Emergency MedicineAuthors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

LITFL Review #165Welcome to the 165th LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the WeekDo you re-spike IV fluid bags? The case of Ruby Chen from gravelessons.com should make us all re-think this. [SO] The Best of #FOAMed Emergency MedicineExcellent discussion of everything you need to know about AFib from EM Cases featuring Ian St...Source: Life in the Fast Lane - January 19, 2015 Category: Emergency MedicineAuthors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Vaccine-Injured Child Stolen by the State and Her Caring Mother Accused of Child AbuseConclusion
For many years, I have been writing about such cases. There are now a growing number of parents who have been falsely accused of harming their vaccine-damaged children. Sadly, this case is yet another example.
Loving, caring parents are having their children taken away from them because the majority of health care professionals and social workers are burying their heads in the sand and choosing to ignore the fact that no vaccine or medication is one hundred percent safe. All vaccines have the potential to cause adverse reactions.
When you have such groups as the AAPS stating, “And yet, children under the age o...Source: vactruth.com - November 22, 2014 Category: Allergy & ImmunologyAuthors: Christina England Tags: Christina England Top Stories Child Protective Services (CPS) Hepatitis B vaccine Kathryn Hughes medical kidnapping Michael Belkin seizure Source Type: blogs

A Quick Lesson on Medical Terminology with 1980’s BatmanToday, I’m digging back in the archive to 1994 to the Knightquest storyline in order to present a brief lesson about medical terminology.
With it’s quasi-Latin and quasi-Greek, medical terms can be confusing and don’t always mean what you expect. Case in point, Batman: Legends of the Dark Knight #59. In this comic, physician Shondra Kinsolving has been kidnapped by her evil step-brother so he can use her telepathic powers to kill from a great distance. Understandably, Shondra doesn’t want to be a part of this, so he brother injects her with a drug of his own invention:
For those of you who may hav...Source: Polite Dissent - February 9, 2014 Category: Family PhysiciansAuthors: Scott Source Type: blogs

A new and very interesting EMR "glitch" - no warnings on stopping a medicine that diminishes the effects of a second medicationA new and very interesting EMR "glitch" from a report I received recently:... I found a glitch with my [name redacted] EMR. It probably happens with all EMRs. I had a patient on primidone (http://en.wikipedia.org/wiki/Primidone) for essential tremor. Later, his primary care put her on warfarin [a "blood thinner" - ed.] for atrial fibrillation. Some time after that, I took her off of primidone. Her INR jumped to 7 or 8. [High - ed.] What happens is that the EMRs warn a physician pretty well if you START a medicine that interacts with warfarin, but fails to warn if you STOP a medicine that interacts with warfarin. If y...Source: Health Care Renewal - October 16, 2013 Category: Health Medicine and Bioethics CommentatorsTags: glitch primidone healthcare IT difficulties warfarin coumadin drug interaction EHR alerts Source Type: blogs

Orexin and InsomniaIf Valium makes you groggy, and Ambien makes you sleepwalk…
A compound that blocks a brain receptor you probably have never heard of may hold the key to the next generation of sleeping pills—and there is always a next generation of sleeping pills.
A new class of hypnotic compounds that serve as antagonists for the neurotransmitter orexin may combat insomnia without the “confusional arousals” that have come to plague some users of zolpidem, otherwise known as Ambien. Sleepwalking, sleep driving, and sleep sex are common among the reports. Orexin is involved in central nervous system arousal. So-called DORAs, or...Source: Addiction Inbox - May 7, 2013 Category: AddictionAuthors: Dirk Hanson Source Type: blogs

Medications that Increase the Risks of Patient FallsFalls are the leading cause of both fatal and non-fatal injuries for adults 65 and older.
Alzheimer's Reading Room
“Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t – perhaps two to three times greater,” said Susan Blalock, Ph.D., an associate professor at the UNC Eshelman School of Pharmacy.
In 2007, more than 21,700 Americans died as a result of falls and more than 7.9 million were injured by a fall including over 1.8 million older adults who had a fall-rela...Source: Alzheimer's Reading Room, The - February 14, 2013 Category: DementiaAuthors: Bob DeMarco Source Type: blogs

What Expiration? Your Drugs May Last A Long TimeNext time you decide to toss that prescription medicine because it appears to have expired, you may want to think twice. Why? A new analysis indicates that some prescription drugs retain their potency long after the expiration date, and the finding also suggests that the healthcare system could save untold oodles of money if expiration dates were sufficiently extended.
To wit, a team of researchers analyzed 14 different medications and found that 12, or 86 percent, tested at concentrations that were at least 90 percent of the amount on the labeling. Three actually had concentrations that exceeded the labeling; just two med...Source: Pharmalot - October 9, 2012 Category: Pharma CommentatorsAuthors: Ed Silverman Tags: Uncategorized Acetaminophen amphetamine Aspirin butalbital caffeine chlorpheniramine Codeine Expiration Date FDA homatropine Hydrocodone meprobamate methaqualone Pentobarbital phenacetin phenobarbital secobarbital Source Type: blogs

Many drugs are just fine years after they 'expire,' study finds - latimes.comhttp://www.latimes.com/health/boostershots/la-heb-expired-drugs-still-work-study-20121008,0,6591417.story?track=rss&utm_source=dlvr.it&utm_medium=twitter&dlvrit=53001 Many drugs are just fine years after they 'expire,' study finds Chances are, your medicine cabinet contains some pills that are past their expiration date. You might even have some pain relievers, some cough syrup or some sleeping pills that were purchased back when Richard Nixon was in the...Source: Dr Portnay - October 8, 2012 Category: CardiologyAuthors: Dr Portnay Source Type: blogs

Dependent on Prescription Drugs, Even Before Birth - NYTimes.comNewly Born, and Withdrawing From PainkillersABBY GOODNOUGH and KATIE ZEZIMAPublished: Sunday, April 10, 2011 at 6:30 a.m. BANGOR, Me. — The mother got the call in the middle of the night: her 3-day-old baby was going through opiate withdrawal in a hospital here and had to start taking methadone, a drug best known for treating heroin addiction, to ease his suffering.The mother had abused prescription painkillers like OxyContin for the first 12 weeks of her pregnancy, buying them on the street in rural northern Maine, and then tried to quit cold turkey — a dangerous course, doctors say, that could have ended in misc...Source: Psychology of Pain - April 10, 2011 Category: Psychiatrists and PsychologistsSource Type: blogs

Which Drugs Increase the Risk of Falling for the ElderlyFalls are the leading cause of both fatal and nonfatal injuries for adults sixty-five and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t—perhaps two to three times greater. -- Susan Blalock, UNC Eshelman School of Pharmacy.....
By Bob DeMarco
Alzheimer's Reading Room
I am always worried that my mother might fall and injure herself -- or worse.
Research studies indicate that falling is a leading cause of injury deaths for people 65 and older -- see Falls Among Older Adults: An Overview.
More than one third of adults 65 and older fall each...Source: Alzheimer's Reading Room, The - January 9, 2011 Category: DementiaAuthors: Bob DeMarco Source Type: blogs

Drug-Drug Interactions to Watch Out ForP450 enzymes and “poor metabolizers.”
The finding, published in Science, is a bit arcane to the layperson. The big secret of how the P450 enzyme family metabolizes drugs turns out to be a critical phase change, where an oxygen molecule temporarily joins the mix, forming “Compound I,” a process the scientists documented by cooling the enzymes at just the right rate.
So what? Well, for starters, “cytochrome P450 enzymes are responsible for the phase I metabolism of approximately 75% of known pharmaceuticals,” write Jonathan Rittle and Michael T. Green at Pennsylvania State University’s Department of Ch...Source: Addiction Inbox - November 22, 2010 Category: AddictionAuthors: Dirk Hanson Source Type: blogs

I'm back at work, so be afraid. But not as afraid as if you'd seen that one doctor.Just a tip from Auntie Jo to the nameless millions of future hospital patients out there: if you sustain a subdural hematoma in a fall at home, and you need that subdural hematoma evacuated, make sure it's a neurosurgeon doing the evacuating.Because if you let just any Fred Friendly into your brainbox, it's possible things could go very wrong indeed. This goes double if you're from Teenyville, that tiny town just south of Wherezat and east of Whadyasay.Grandma took a fall a couple of weeks ago at home and conked herself on the head. It wasn't a very big conk, or a very painful one, but Grandma, being the careful sort (and ...Source: Head Nurse - November 16, 2010 Category: NursesAuthors: Jo Source Type: blogs

this morning…This morning, while I was in the living room and Emma was asleep in her crib in our bedroom, I heard a faint “Mommy” followed by a very distinct “Mommy!”. She was calling me to come and get her out of her bed. When I walked in to greet her, I asked her if she called for me and she smiled and nodded her head yes!
This interaction did my heart so much good!
She has repeated my name when I say it first, but this is the first time she has associated a name with a person (that wasn’t even in the room!), and it just so happened to be MY name! THEN when I asked if she had actually called my name, she...Source: Especially Heather - August 3, 2010 Category: CancerAuthors: Especially Heather Tags: Emma Emmas Eyes Go God! Thankful Working On Me Source Type: blogs

nodding off {and “nubbie” returns!}Emma was back in the hospital last week, but it was a quick trip. She went in because she had a urinary tract infection, and while there we opted to have a G-Tube placed. On Tuesday of last week she was officially diagnosed with Cortical Vision Impairment (CVI) by her Neuro-Ophthalmologist. We {Mark, I and her doctors} feel that the G-Tube is needed because Emma has limited vision and was not allowing us put anything in her mouth because she thought everything was medicine. If you have followed my blog for the past 4 years, you will remember that she use to have a G-tube that she loving called “nubbie”. She pul...Source: Especially Heather - June 4, 2010 Category: CancerAuthors: Especially Heather Tags: Emmas Eyes God is Good Hospital/Emma Thankful Source Type: blogs

Prescription Medications that Increase the Risks of Patient FallingResearchers at the University of North Carolina at Chapel Hill have created a list of prescription drugs that increase the risk of falling for patients aged 65 and older.....By Bob DeMarco
Alzheimer's Reading Room
“Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t – perhaps two to three times greater,” said Susan Blalock, Ph.D., an associate professor at the UNC Eshelman School of Pharmacy.
In 2007, more than 21,700 Americans died as a result of falls and m...Source: Alzheimer's Reading Room, The - May 27, 2010 Category: DementiaAuthors: Bob DeMarco Source Type: blogs

A nurse practitioner is valuable in hospice and palliative careby Patrice Villars
Recently, a physician colleague expressed her concern about signing routine hospice admission orders for her elderly patient with end stage heart failure. The routine ‘as needed’ (PRN) orders included phenobarbital, pentobarbital, haloperidol, lorazepam, and morphine. “The hospice nurses know more about this than I do, don’t they?” she said.
Yesterday, a longtime palliative care nurse told me she didn’t want to put her mother with end stage heart failure in a nursing home with hospice, because “they’ll just give her morphine and Ativan. I want her heart failure managed.”
I worked as a ...Source: Kevin, M.D. - Medical Weblog - February 28, 2010 Category: Family PhysiciansAuthors: Kevin Tags: Patient care primary care Source Type: blogs

Effexor to Cymbalta: Not So BadYou know, if you rely on the Internet to inform you about medication side effects, you might have a panic attack before you’ve even got the Ativan in your system to calm you down. When I started Effexor, I read such horror stories that I was absolutely terrified, and though some of the info was true, that drug pulled me out of an unbearable abyss. I was truly losing it — the depression was becoming psychotic and I was contemplating suicide. And who knows why, because such things are mysterious, but it worked.
The thing about Effexor that I didn’t like was my dependence on it. For instance, if I miss a nig...Source: The Trouble With Spikol - February 5, 2010 Category: Mental IllnessAuthors: liz Tags: Uncategorized Source Type: blogs

Dear Son Medical Update~HomePhoto of Dear Son's Tendercare Hospital BedWe just got home from the hospital yesterday. Since I last wrote, we made a lot of progress.For the pneumatosis, Dear Son completed the antibiotics they prescribed. They had him on a seven day course which was done as a precaution. One of the causes of the pneumatosis intestinalis can be infection and although he didn't show any signs of that, they prescribed a seven day course, just in case.In addition, they took him off of the Miralax and changed his Phenobarbital from a liquid form to a pill form. One other cause of pneumatosis can be medications. In this case, they know that t...Source: Dream Mom - January 15, 2010 Category: Other ConditionsAuthors: Dream Mom Source Type: blogs

---We just got home from the hospital yesterday. Since I last wrote, we made a lot of progress. For the pneumatosis, Dear Son completed the antibiotics they prescribed. They had him on a seven day course which was done as a precaution. One of the causes of the pneumatosis intestinalis can be infection and although he didn't show any signs of that, they prescribed a seven day course, just in case. In addition, they took him off of the Miralax and changed his Phenobarbital from a liquid form to a pill form. One other cause of pneumatosis can be medications. In this case, they know that too much Sorbitol can sometimes cause this...Source: Dream Mom - January 15, 2010 Category: Other ConditionsAuthors: Dream Mom Source Type: blogs

Dear Son Medical Update~ProgressDear Son remains at Big Academic Medical Center and will be there through Wednesday. GI and GI surgeons poured over the CT scan of the abdomen and have seen Dear Son. GI surgery states that he has Pneumatosis Intestinalis. Essentially, Dear Son has a significant amount of free air in the lining of the bowel wall. They are not sure how it got there however typically there are a few causes of this: 1) medication, 2) infection and 3) not enough blood flow to the area. This condition is typically seen in preemies but rarely in adults. The free air is located on the right side of the bowel lining and some on the left. In Dear S...Source: Dream Mom - January 10, 2010 Category: Other ConditionsAuthors: Dream Mom Source Type: blogs

New concepts in status epilepticusFrom a review in Emergency Medicine Clinics of North America, here are a few key points: Definition of SE--- Traditional: 30 minutes of unrelenting seizure(s). New (proposed): greater than 5 minutes or two or more without intervening full return of consciousness. Why? The longer durations traditionally used to define SE were selected based on assumptions about underlying pathophysiology that are now known not to be true rather than on any kind of clinical relevance… Data from continuous electroencephalographic (EEG) monitoring indicate that the average length of a benign, self-limited, adult generalized tonic-clonic se...Source: Notes from Dr. RW - November 25, 2009 Category: Internists and Doctors of MedicineSource Type: blogs

Are hospice doctors relying too much on symptom scores to assess pain?by Eric Widera, MD
A recent issue in The Lancet included an article entitled “The Death of Ivan Ilyich and pain relief at the end of life.” This is a thought provoking article focused on the question of whether there is overuse of pharmaceuticals to treat various forms of suffering in hospice and palliative medicine.
The authors argue that a good death, as seen through their interpretation of The Death of Ivan Ilyich, may include physical and existential suffering. Tolstoy’s character finds redemption in his suffering; he remains conscious through the agony of a prolonged and painful death and ends up with a greater ...Source: Kevin, M.D. - Medical Weblog - September 29, 2009 Category: Family PhysiciansAuthors: Kevin Tags: Diagnosis and treatment cancer drugs hospital specialist Source Type: blogs

More About Folic AcidDeficiency of folate/folic acid is believed to be one of the most common nutritional deficiencies because only an estimated 11% of people consume the recommended 5-7 servings daily of vegetables and fruits. Here are four other causes of this deficiency.
Most members of the vitamin B-complex must be converted to a metabolically active form in the body. The active form of folates in foods and folic acid in supplements is called 5-methylenetetrahydrofolate or MTHF for short. This complex conversion requires good intestinal and liver function, adequate amounts of vitamins B2, B3, B6, C, plus zinc and serine. Produced in the l...Source: Renegade Neurologist - A Blog by David Perlmutter, MD, FACN - September 23, 2009 Category: NeurologistsAuthors: Dr. Perlmutter Tags: Heads Up Source Type: blogs

Dear Son UpdateThings don't seem to be going particularly well right now. Yesterday Dear Son had a terrible seizure in the morning. I had started his feeding and went in to put in my contact lenses and when I came back, he was having a seizure. I used the magnet to activate his vagus nerve stimulator twice however the seizure escalated so fast, that I had to take immediate action. I can't remember a time when it escalated this fast and it made me quite nervous. I gave him some Diastat, an emergency rectal medicine that I keep in his nightstand. It usually works right away. When that didn't stop it, I debated whether I should call 911 or ...Source: Dream Mom - July 24, 2009 Category: Other ConditionsAuthors: Dream Mom Source Type: blogs

Getting Off Alprazolam (Xanax): The need for RecoveryA comment on my old blog referred to a discussion about the withdrawal from Xanax, or Alprazolam, a short half-life benzodiazepine:
Clonazepam (Klonopin) actually is not the drug of choice used in benzo withdrawal, rather it is diazepam (Valium). Clonazepam It is not a very long-acting drug, with a half-life of only 18-50 hours; diazepam’s half-life is 20-100 hours, with its metabolite hanging around for twice that long.
Absolutely the worst thing about benzo withdrawal (take it from me) is that it never ends. That is why I still take them.
Sadie
My Response:
The ‘drug of choice’ for benzo withdrawal dep...Source: Suboxone Talk Zone - November 30, 2008 Category: AddictionAuthors: SuboxDoc Tags: 12 steps addiction benzos mood recovery withdrawal AA anxiety clonazepam valium xanax xanax withdrawal Source Type: blogs

House — Episode 4 (Season 5): “Birthmarks”An interesting mystery and clever solution weakened by a diagnosis that requires way too much coincidence and overlooking more obvious answers.
Nicole is a 25 year old Chinese woman raised in New Jersey who was given up for adoption as a young infant. She is back in China trying to find her birth parents. While in a temple there, she suffered a sudden attack of excruciating abdominal pain and started to vomit blood. By the time she has returned to the US and been admitted to Princeton Plainsboro, the Chinese surgeons have removed a foot of bowel.
The team’s initial suspicion is a Meckel’s diverticulum (a defec...Source: Polite Dissent - October 15, 2008 Category: Family PhysiciansAuthors: Scott Tags: newtag Source Type: blogs

Understanding The Nature And Effects Of AddictionWe may not realize it but most of us have experienced certain types of addiction in our lifetime. Although some types of addiction are rather harmless, there are certain types of compulsive cravings that can have devastating to our health and our lives. What is really scary about these compulsive cravings is that it could not be appeased easily. In most cases, the cravings are so intense that the person would do just about anything to satisfy him/herself.
Drug Addiction
Some of the most destructive types of compulsive cravings are those cravings that are induced by drugs and other substances. Some of the most common types ...Source: Addiction Recovery Blog - May 2, 2008 Category: AddictionAuthors: Karen Halls Tags: Addiction Addiction Recovery Addiction Help Addiction Articles Source Type: blogs

Anticonvulsant hypersensitivity syndrome (AHS) was recently reviewed in Pharmacotherapy (free full text via Medscape).Key points:AHS belongs on the clinician’s list of dermatologic emergencies.Phenytoin, carbamazepine, and Phenobarbital lead the list of causative agentsNot only many clinicians, but also computerized pharmacy databases, are unaware of potential cross sensitivity among several anticonvulsants.Valproic acid, benzodiazepines and other nonaromatic anticonvulsants should be safe. (Rare reports of valproic acid related AHS do exist).Look for a triad of fever, rash and internal organ involvement (usually in the form of liver function abnormalities). F...Source: Notes from Dr. RW - February 27, 2008 Category: Internists and Doctors of MedicineSource Type: blogs

Educate You Self With The Drug Addiction TreatmentOne of the most important decisions you will make in your lifetime is selecting a drug addiction treatment for you or one of your love ones. Only few of us know about the most important drug addiction treatment center for you as they are not all the same, you want quality and trust. You will find that each drug addiction treatment program or center will have its own option, cost, effectiveness of them.
Let’s face it. One of the perennial societal problems the whole world is facing right now is drug addiction. It seems like we are losing every one of our people, youth especially, to substance abuse that continuously d...Source: Addiction Recovery Blog - February 15, 2008 Category: AddictionAuthors: Karen Halls Tags: Addiction Addiction Recovery Addiction Help Addiction Articles Source Type: blogs

More responses to what's become an interesting discussion of suicideFrom Sally:
I don't know if I've posted this before. Once I made a a suicide gesture (that's what the therapists call it). I had left my ex husband, and was suffering from heartbreak, betrayal, fear, etc. I walked into the bathroom where my mother had left a big bottle of phenobarbital on the counter, looked at myself in the mirror and decided I didn't deserve to live through such misery and I took the pills. I then went back to my Dad's office, sat down and waited to die. After a few minutes I walked back in to the bath room, looked myself in the mirror and thought, in the grand scheme of things even if I live to be 100,...Source: The Trouble With Spikol - December 31, 2007 Category: Mental IllnessSource Type: blogs

The CYP2D6 FactorEnzymes And Drug AbuseDifferent drugs effect different people differently.Drugs are broken down into their constituent waste products by specific sets of enzymes. A subset of the human population, variously estimated at 3% to 7%, are categorized as “poor metabolizers.” For them, a drug’s recommended dosage is often far too high. The culprit is a gene variant that codes for a liver enzyme called cytochrome P450 isoenzyme 2D6, known in shorthand as CYP2D6. Poor metabolizers produce less of this crucial enzyme, which means that drugs are broken down and excreted at a much slower pace. In these people, the recommended do...Source: Addiction Inbox - November 15, 2007 Category: AddictionTags: drug addiction CYP2D6 alcoholism drug abuse enzyme Source Type: blogs

Catching UpIt's been a busy past few weeks which has been difficult carving out some time to write.Dear Son is doing better now. Since his admission to Big Academic Medical Center in August, he's had a tough time. At that time, the Attending thought that we should try and reduce Dear Son's medicine by eliminating the Phenobarbital. The Phenobarbital can metabolize some of the other meds faster and therefore requiring you to use more of them. Theoretically, as you removed the Phenobarbital, the levels of the other meds would increase, therefore allowing you to reduce the other medications as well, since it would take less of them to m...Source: Dream Mom - October 30, 2007 Category: Other ConditionsAuthors: Dream Mom Source Type: blogs

Highlights From Friday's Pill Counting Action.It was 9:30 and I was worried. I had taken the usual opening flurry of phone calls, which were, in order, people checking to see if their Vicodin, Valium, Soma, Vicodin and Vicodin were ready to pick up, but none of them were from John. I checked the calendar to make sure it was Friday. Never had I worked at this store on a Friday morning and had John fail to call to check on his Vicodin by now. I briefly considered the possibility that John had finally learned that not once had any of these calls resulted in anything other than "it's a little too soon to fill that John"Briefly considered the possibility I said. I knew it ...Source: Your Pharmacist May Hate You - October 15, 2007 Category: Pharmacists and PharmacologistsTags: Wacky Customers And Other Work Rants Source Type: blogs

Mixing Large Doses Of Common Painkiller And Caffeine May Increase Risk Of Liver DamageFrom Science Daily
Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS’ Chemical Research in Toxicology. The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.Health...Source: Renegade Neurologist - A Blog by David Perlmutter, MD, FACN - October 3, 2007 Category: NeurologistsAuthors: Dr. Perlmutter Tags: Heads Up Source Type: blogs

UpdateDear Son continued to sleep through the night on the new dose of medicine however he also began sleeping through the day as well. As a result of the increased meds, his EEG did not show any seizures, although it did show abnormal activity. Since that time, they have reviewed his seizure meds and decided to remove the Phenobarbital. The Phenobarbital, causes the other medicines to metabolize faster. Once they remove this, the drug levels of the other medicines should increase and therefore they will be able to reduce his overall number and quantity of medications since it will take less medicine to attain a therapeutic leve...Source: Dream Mom - August 15, 2007 Category: Other ConditionsAuthors: Dream Mom Source Type: blogs

The Slippery Slope Slip-Sliding Away in OregonHere is an interesting--and predictable--turn of events: Two nurses are being investigated by law enforcement for engaging in assisted suicide, although the facts look more like a euthanasia. From the story:Two Portland-area nurses gave [cancer patient Wendy Melcher] massive amounts of drugs intended to cause her death. The drugs were administered in what the nurses would later call an assisted-suicide plan directed by Melcher. The nurses have admitted to the Oregon State Board of Nursing that they administered doses of morphine and phenobarbital without informing Melcher’s physician. Oregon’s Death With Dignity Act--t...Source: Secondhand Smoke - July 6, 2007 Category: Health Medicine and Bioethics CommentatorsAuthors: Wesley J. Smith Source Type: blogs

History Repeating?Good ol’ Donnatal.
One of my co-workers has the new Mosby drug book and was looking up a few pharmaceuticals during a spare moment the other night.
Did you know that Donnatal elixir is twenty-three percent alcohol?
Holy ETOH!
On evening shift a few decades ago (literally), I was suffering from horrible stomach pain, enough that I was unable to function. In a unit with only two RNs on duty, this was a problem.
The ER doc on duty said, “Oh, go take two teaspoons of Donnatal and that will take care of it.”
I had no idea what Donnatal was, having never given it before. It was up in the cupboard (this was pre-...Source: Emergiblog - June 6, 2007 Category: NursesAuthors: Kim Tags: Blog Source Type: blogs

Coffee and Your HeartRecent research shows that coffee drinkers come in two flavors: “fast” metabolizers and “slow” metabolizers. People with a particular gene variant are more vulnerable to it’s effects. The gene in question controls the production of a key enzyme, known as CYP1A2, responsible for metabolizing coffee in the liver. People who inherit the slow version face a greater risk of non-fatal heart attacks at high levels of caffeine intake.“The association between coffee and myocardial infarction [heart attack] was found only among individuals with the slow CYP1A2 allele [gene variant], which impairs caffeine metabolismm, su...Source: Addiction Inbox - March 4, 2007 Category: AddictionTags: heart caffeine coffee addiction heart disease Source Type: blogs

----> Click here to go to the beginning…
Start he...----> Click here to go to the beginning…Start here today.Toby's Blog Day 2-Part IWell, I thought for a moment things were looking up today. First, I got the good news that Toby was doing so well that they were going to take his tube out. I was glad. They said that once they did that and he was stable, I could see him. Finally!!! I’ve waited nine months and then some for this moment. They said they would bring him by shortly and the neonatalogist would stop by to answer any of my questions and to explain what happened last night.In the meantime, Tom called and said his flight was delayed. I gave him the good news that T...Source: Dream Mom - February 26, 2007 Category: Other ConditionsAuthors: Dream Mom Source Type: blogs

VaporizedThe Vapotherm machine was a device that allowed neonatologists to give high amounts of humidified oxygen to babies through their noses, higher than we could with any other device except CPAP. I knew that some NICU's were using it in place of CPAP, so when one of my partners said, "Hey, we should get a Vapotherm," I decided to look for studies in neonates using it.I found none. In fact, I could find reports of its use in only about 5 neonates, and certainly no well done study assessing its safety or effectiveness. I, and others, had concerns that we might be giving too much oxygen and air flow to a baby, without knowing the...Source: Neonatal Doc - February 12, 2007 Category: PediatriciansSource Type: blogs

EvidenceSome of the comments in my previous post Implants brought up the issue of evidence based medicine in the NICU. Evidence based medicine means using medical therapies that have been tested in well done studies and found to be beneficial, as opposed to practicing medicine according to the "Hey, this sounds like a good idea, let's see if it works" method. I am all in favor of using evidence based medicine and think that generally I practice it, but I have to say it's easier said than done.There are a couple of ways by which people may fail to practice evidence based medicine. Some neonatologists, and physicians in general, fai...Source: Neonatal Doc - February 5, 2007 Category: PediatriciansSource Type: blogs